Preparing Millennial Nursing Students for Practice: Aligning Clinical Course Outcomes with Professional Practice Standards Presented by: Pam Stetina, PhD, RN, CNE Douglas Sutton, EdD, MSN, APRN, NEA BC Session Disclosure 1) Approval Statement This continuing education activity was approved by the Western Multi State Division, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Arizona, Colorado, Idaho, and Utah Nurses Associations are members of the Western Multi State Division. Approval # 72 17 2) Criteria for Successful Completion To receive contact hours, participants must check in to the session using the barcode scanner, attend the entire session and then complete both the session evaluation and full conference evaluation by July 31, 2017. 3) Conflicts of Interest This educational activity does not include any content that relates to the products and/or services of a commercial interest that would create a conflict of interest. 4) Commercial Support There is no commercial support being received for this session. Learning Outcome One Describe how aligning course outcomes with professional practice standards enhances critical thinking and problem solving in the millennial student. 1
The Millennial Student 1980 2000 AKA generation Y, gen next, net generation By 2030, expected to make up 75% of U.S. workers How Millennial Are You? Millennial Characteristics Technologically savvy Multi taskers Structured Nurtured Collaborators Attention Millennials in the Workplace Olson (2009) study: Being in unfamiliar surroundings Out of the blue Finding my voice Christmas (2008) Structure Technology Balance Collaboration 2
Critical Reasoning in the Workplace Johanson (2012) Quick answers Impatient and bored Complacency Attention spans No accustomed to reflective, systematic thinking ACCREDITATION: FOCUS ON CRITICAL THINKING Why Accreditation is Important Sets and assesses standards Holds nursing programs accountable to the community of interest Evaluates success Fosters continuing improvement Recognizes successes publically Nursing education and practice must work together to better align education with practice environments (CCNE, 2013, p. 5). 3
Definitions CCNE (2008, p. 36): Critical Thinking: All or part of the process of questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity (AACN, 1998). Critical thinking underlies independent and interdependent decision making. Clinical Judgment: The outcomes of critical thinking in nursing practice. Clinical judgments begin with an end in mind. Judgments are about evidence, meaning and outcomes achieved (Pesut, 2001). Clinical Reasoning: The process used to assimilate information, analyze data, and make decisions regarding patient care (Simmons, Lanuza, Fonteyn, & Hicks, 2003). Definitions ACEN Spirit of Inquiry: A yen to discover (Van Bree Sneed, 1990, p. 36). Asking questions to satisfy one s curiosity (p. 37). NAU Critical Reasoning Professional nursing practice is grounded in the translation of current evidence to inform practice and make clinical judgments. Knowledge and skills in nursing, information management and patient care technology are critical in preparing professional nurses to deliver quality patient care in a variety of healthcare settings. Critical thinking underlies effective clinical reasoning and judgment. In addition, the practice of critical reasoning depends on an attitude of inquiry, and openness to innovation and continued learning. 4
Critical Reasoning Program Outcomes Upon completion of the BSN program, the successful graduate: Synthesizes evidence and nursing knowledge to evaluate and modify clinical nursing practice, in order to provide holistic, safe, comprehensive, patient centered care. Integrates reliable evidence from multiple ways of knowing to inform practice and make clinical judgments. Mapping of Essentials to Program Outcomes NUR 451 Outcomes Upon completion of the course, the successful student: Provides nursing care which is evidence based, holistic, safe, patient centered, and comprehensive. Synthesizes evidence and nursing knowledge to evaluate and modify clinical nursing practice, in order to provide holistic, safe, comprehensive, patientcentered care. Integrates reliable evidence from multiple ways of knowing to inform practice and make clinical judgments. Example of Mapping Clinical Course Mapping to Essentials 5
PRACTICE STANDARDS: FOCUS ON CRITICAL THINKING Why are Practice Standards Important Reflect expectations of nursing practice in real world Promote clinical practice Improve patient care Provide framework for evaluation Helps identify areas for improvement (Davis, 2014) Learning Outcome Two Discuss how aligning course outcomes with professional practice standards translates to measurable value for key stakeholders (students, faculty, facilities, and patients). 6
How does aligning course outcomes with professional practice standards translates to measurable value for key stakeholders? 1. Students: Enhances employability skills and competencies 2. Faculty: Aligns course content with national practice expectations within the discipline 3. Facilities: Minimizes transition from student to novice professional nurse 4. Patients: Assures patient population that care provider is aware of and practicing within role expectations of the novice registered professional nurse Employer Based and Career Ready Information How can YOU help your new graduates RISE above the competition? Incorporate the term: Employability Skills into your practicum course Assist your students understand the importance of transferable skills, AKA soft skills: critical thinking leadership communication collaboration These types of skills are deemed by employers as high priority traits self motivation written communication global (health) fluency teamwork Key Employability Skills Educators are expected to ensure that students are learning the K,S,A s of professional nursing (Where K = Knowledge, S = Skill s, A= Abilities or Aptitude) Employers are continuing to demand a more highly trained and well educated nursing workforce 7
The National Association of Colleges and Employers (NACE) have identified eight competencies associated with career readiness. This presentation will focus on just ONE: Critical Thinking and Problem Solving NACE defines this as: The ability to exercise sound reasoning to analyze issues, make decisions, and overcome problems. Aligning Course Outcomes with Professional Practice Standards for Critical Thinking and Problem Solving using College/School, AMSN and Employer Based Criteria Course Example of Critical Reasoning (Standard Syllabus Content) College/School of Nursing Approved Provides nursing care which is evidence based, holistic, safe, patient centered, and comprehensive. Synthesizes evidence and nursing knowledge to evaluate and modify clinical nursing practice, to provide holistic, safe, comprehensive, patient centered care. Integrates reliable evidence from multiple ways of knowing to inform practice and make clinical judgments. 8
AMSN Definition The scope of medical surgical nursing practice is intricately linked with the standards of medical surgical nursing practice. The specialty standards described provide the foundation for medical surgical nursing practice by delineating the standards of care and the standards of professional performance. These standards, built on the broader general standards of nursing practice as defined in Nursing: Scope and Standards of Practice (ANA, 2010a), are accompanied by specific measurable criteria. These criteria include key indicators of competent nursing practice in the specialty of medical surgical nursing. AMSN Definitions Standards of Care describe a competent level of nursing care as demonstrated by the nursing process, involving assessment, diagnosis, outcome identification, planning, implementation, and evaluation. Standards of Professional Performance describe a competent level of behavior in the professional role including activities related to quality of care, performance appraisal, education, collegiality, ethics, collaboration, research, and resource utilization. Guidelines are systematically developed statements based on available scientific evidence and expert opinion. Guidelines are specific to a clinical condition and assist the nurse in clinical decision making by describing recommended courses of action for specific client conditions. Example of Integrated Outcome (School + AMSN) 3A. NUR 451: COURSE EXPECTATION CRITICAL REASONING (Definition) Student nurses are expected to acquire and utilize current knowledge in nursing practice, and to pursue knowledge to enhance nursing knowledge and practice. 9
Rationale: Why do I need to know this? Including this instills value for the Adult Learner Scientific, cultural, social, and political changes require a continuing commitment from the student nurse who, as an adult learner, must pursue knowledge to enhance nursing care and to transition to a professional nurse. In addition to formal coursework, the professional nursing student is expected to enhance their knowledge through additional education and outside activities as a means for professional growth. Student nurses have primary responsibility for ongoing education and professional development in their assigned practice setting and primary patient/client population. Measurement Criteria (How will I be evaluated on this course expectation) 1. Participate in educational activities to improve clinical knowledge, enhance role performance, and increase knowledge of professional issues and technologies, including information technology used in the assigned clinical setting. 2. Actively and regularly seek experiences to develop and maintain clinical skills and competence. 3. Acquire knowledge and skills appropriate to the practice setting by participating in educational programs and activities, facility based conferences or workshops, or independent learning activities. 4. Continually increase knowledge of cultural, political, scientific, agerelated, and social issues related to the client s health care. Job Description Dissection for Critical Thinking and Problem Solving Example Registered Nurse Med/Surg Tele 1. Prioritization and problem solving skills to meet changes in patient status/condition and implementing corrective actions as indicated; including reporting changes to appropriate personnel. 2. Continually assesses the needs and conditions of assigned patients by gathering relevant patient health information. 3. Effectively identifies outcomes, develops a plan of care individualized to the patient and/or situation, and implements the identified plan appropriate for the attainment of the expected outcomes. 10
Job Description Dissection for Critical Thinking and Problem Solving Exercise Registered Nurse Med/Surg Tele 4. Continually assesses patient s progress toward the attainment of outcomes and effectively revises/updates diagnoses, outcomes and plans of care as appropriate. 5. Actively participates in creating and sustaining a learning environment supported by evidenced based practice and research; focusing on personal development areas. 6. Achieving and maintaining a level of knowledge/competence in one s chosen area of expertise necessary to effectively/safely perform all of their duties and responsibilities; keeping abreast of current trends and developments. See separate handout References: Session Evaluation To evaluate this session, please do the following: 1. Go to 2017necintherockies.sched.com/mobile (the online schedule) on your mobile device 2. Click on the session you attended 3. Press Feedback Survey 4. Complete survey for the session *Remember to enter your unique identifier located on the back of your badge when completing survey. 11